This interview is from theSpring 2013 issue of Vegan Views No.127(link to pdf 5MB), which also includes articles by Teresa Bergen on her
recent visit to see the amazing wildlife in the Galapagos islands,
Debbie Andrews on the environmental impact of plastic, and Zion Lights
on gardening the vegan way. See here for full contents of issues 121-127 including interviews with John Davis (International Vegetarian Union), Angel Flinn (Gentle World vegan community),
David Irving (author of 'The Protein Myth'), David Graham (Vegan
Organic Network), Lee Hall (author and animal rights activist), and
Patrick Smith (Veggies Catering).

Could
you begin by telling us a little about yourselves and your paths to
veganism?

Jack Norris: My path to veganism started on a
fishing trip I took while in college. It had always bothered me how
people treated animals with no regard to their feelings, and
witnessing the fish struggle to breathe made me seriously question
our treatment of animals.

Eventually
I got some information from PETA that persuaded me to give up eggs
from battery cage hens. Soon after, I stopped eating mammals and
birds, then fish, and finally became vegan. I got involved in animal
advocacy and in 1993 co-founded Vegan Outreach.

Vegan
Outreach produces booklets exposing the conditions on modern day
animal farms and in slaughterhouses. We personally hand them to
millions of pedestrians each year, mainly at colleges in the U.S. and
Canada.

I
became a Registered Dietitian in 2001 after coming across numerous
people who said they had been vegan or vegetarian and had not been
healthy. I wanted to address this, along with other nutrition issues
surrounding a vegan diet. Now I maintain the websites
www.VeganHealth.org and
www.JackNorrisRD.com

When
I'm not doing my various jobs, I like to play ultimate frisbee and
lift weights.

Ginny Messina: It’s interesting that Jack and
I both ended up as vegan dietitians who bring fairly similar
perspectives to our work, since we followed very different paths to
get here. Vegetarian or vegan diets weren’t really on my radar when
I started out in
dietetics. I came to vegetarianism through the kitchen - newly
married and experimenting with different cooking styles.

As
someone who has always cared deeply about animals, but just wasn’t
making the connection with the food on my plate, I was ready for a
vegetarian message. I found that message in the 1970s cookbook
Laurel’s Kitchen, which was dedicated to a “glossy black calf on
his way to the slaughterhouse many years ago”. I don’t know why
those words hit me so profoundly and changed the way I was to eat
(and live) forever, but reading them started me on a path towards a
very different kind of life
and career.

It
was several years later when I went to work for the Physicians
Committee for Responsible Medicine (PCRM) that I had my first
exposure to a vegan message and an animal rights ethic. That’s an
ethic that really touches on all parts of my life now because it
underscores my work and all of my lifestyle choices. When I’m not
working on vegan nutrition projects, I’m involved in local animal
issues related to spay/neuter programs and the animal shelter.

When
I can grab a little bit of leisure time, it’s usually spent
reading, practising piano, learning to knit, and working in the
garden.

What
prompted you to write Vegan for Life?

Ginny Messina: I had been working
on and off on a book for several years before Jack approached me
about writing Vegan for Life. I
had this idea that vegans needed a book that they could read in just
a few hours - something that offered just enough information to give
vegans confidence that they are making good food choices. My concern
has long been that many vegans are not getting reliable nutrition
information, and so I wanted to write something that was very
accessible and balanced.

Jack Norris: We also felt that there needed to
be an updated, comprehensive yet concise guide to eating vegan.
Becoming Vegan by Brenda Davis and Vesanto Melina had been that
guide, but it had not been updated in many years, during which time
much pertinent research had been conducted. For example, about ten
studies were published showing vegans who did not supplement their
diets with vitamin B12 had elevated homocysteine (greatly elevated in
many cases) which can lead to stroke, dementia, and other long term
illnesses.

Studies
on vegans and calcium needs had been indicating vegans were not
getting enough calcium, and I had come across many vegans who had
become vitamin D deficient and suffered from severe fatigue. These
issues needed to be addressed.

In the introduction to Vegan
for Life you list the “top ten myths about vegan diets”. Which do
you consider to be the most persistent of these myths and how can we
best dispel it?

Jack Norris: In the book we phrase one myth as "vegans
need less calcium than omnivores", but my biggest concern is for
vegans who think they don't need to pay attention to calcium. If a
vegan isn't aware of how they are specifically getting enough
calcium, then there is a very good chance they aren't. Only a few
leafy greens are high in absorbable calcium - collard greens, turnip
greens, mustard greens, and kale. If you are not eating at least
three servings of those foods a day (one serving is ½ cup cooked),
then you need to be having calcium fortified non-dairy milk (or
another calcium-fortified food), calcium-set tofu, or taking a
calcium supplement to ensure you are getting enough calcium.

Ginny Messina: It’s hard to choose just one! I think the most important myths are
those pertaining to vitamin B12 and calcium. I still encounter vegans
on a very regular basis who don’t want to believe that they need
vitamin B12 supplements.

These
myths about B12 and calcium get repeated over and over again in the
vegan community, sometimes even by those who are in positions of
considerable authority in that community.

This
was a big reason for writing Vegan for Life. We wanted to provide
solid evidence to counter those beliefs and help vegans make optimal
food choices.

Many vegans place great faith in the China
Study, and the book of the same name by Professor T Colin Campbell.
However, you do not cite results from the study in Vegan for Life,
saying that it “doesn’t provide information … on the health of
vegans”. Would you care to explain to readers why the findings of
the China Study are largely irrelevant to vegans?

Jack Norris: The
China Study is an ecological study, which means that it pools
information from different populations, in this case different
regions of China, and compares the averages among the groups, rather
than from individual subjects.

There
is certainly nothing wrong with doing this - it gives researchers an
idea of what about those regions might be useful for further
research, looking at individuals rather than regions. We now have a
great deal of data on many of the disease markers of actual vegans,
and some data on their disease rates, through the Oxford Vegetarian
study, EPIC-Oxford, studies of Seventh-day Adventists, and a few
other studies. That data, which is highly relevant to vegans at
large, is what we focused on in the book.

Ginny Messina: I would add that the findings from the China Study aren’t exactly
irrelevant to vegans. Any well-designed study like the China Study
that looks at health impacts of animal versus plant foods has
relevance to vegans. However, because it didn’t include vegan
subjects, the China Study doesn’t speak specifically to the health
of vegans. We can’t look at that data
and conclude that vegans are healthier than lacto-ovo- vegetarians or
pesco-vegetarians, for example.

Something that is also a
little bit unique to our book is that we wanted to help readers
understand that some types of studies carry more weight than others -
or that they have different purposes. As Jack pointed out, ecological
studies, which include the China Study, generate findings that
stimulate further research. But they aren’t the type of studies
that allow us to make statements about causal relationships between
diet and health.

In
fact, there are instances where ecological studies have led us
completely astray. For example, the belief that vegans have lower
calcium needs than omnivores comes, in part, from an ecological study
that compared rates of hip fracture to
protein intake around the world. It showed that hip fracture rates
were highest in countries with the highest per capita protein intake.
The obvious conclusion is that eating protein causes weak bones. But
it’s turning out that this conclusion may in fact be wrong. There
are other explanations for the differences in hip fracture rates in
these countries, all of which are missed in ecological studies.

What
are the main advantages of a well-planned vegan diet?

Jack Norris: On average, vegans have lower LDL (low-density lipoprotein) and total
cholesterol levels. In studies done on healthy populations, vegans
have had an average cholesterol level of 160 mg/dl (4 mmol/l)
compared to 202
mg/dl (5 mmol/l) for regular meat eaters.

Vegans
also have lower levels of triglycerides, which is interesting because
many clinical trials have shown that high carbohydrate diets raise
triglyceride levels; apparently this isn't the case for vegans.
Vegans are less likely to have high blood pressure, and more likely
to have lower body weight.

Best
of all, after adjusting for all the factors that might affect
diabetes, vegans have been shown to have a 62% lower risk of diabetes
than regular meat-eaters. Not bad!

Ginny Messina: I agree that the
findings regarding health benefits for vegans are encouraging. I’m
not quite convinced that a person needs to be 100% vegan to reap
them, since it’s a theory that hasn’t been tested. But,
definitely, a person who is eating a
typical American or British diet is extremely likely to see some
improvements in their health by switching to a vegan diet; a drop in
cholesterol level at the very least.

But,
what we tried to do in our book was to recognize those advantages
without over-promising any particular health benefit. Not all vegans
are slender and not all vegans are protected from heart disease and
cancer. I always think of
those health benefits as a nice little perk anyway. The real
advantage to me is the positive impact we make with a vegan
diet.

What are the main disadvantages of a vegan diet and how
can they be overcome?

Ginny Messina: Aside from vitamin B12 and vitamin
D, we know that all nutrient needs can be met through consumption of
plant foods. The real disadvantage is that western cultures rely on
animal foods for many of their nutrients and so vegans don’t have
cultural or family habits to fall back on. I grew up getting calcium
from milk and if you had taken that milk away, my mother would not
have had any idea what to feed me to ensure adequate calcium intake.

The
fact is that a vegan diet is a foreign way of eating for most people
and so we have to actually learn how to meet nutrient needs. It’s
not hard; it’s just different. We do need to learn where to get
calcium and iodine, and we have to work a
little bit harder to ensure adequate intake of zinc and adequate
absorption of both zinc and iron. We also need to
ensure adequate vitamin D, although that’s an issue for everyone,
vegan or not.

Jack Norris: You should make sure you have a reliable
source of vitamin B12, calcium, iodine, vitamin A, and omega-3 fatty
acids. For some people, vitamin D, zinc, and iron could also be
issues. Rarely will protein be a problem unless someone doesn't eat
legume products.

Which aspects of the health of vegans require
further research?

Jack Norris: Docosahexaenoic acid (DHA) is a
long-chain omega-3 fatty acid and the main dietary sources for
omnivores are fish and eggs. DHA is much lower in the blood of vegans
who do not take DHA supplements than in the blood of omnivores, but
it is not clear if these lower DHA levels matter. My main concern is
with the possibility of low DHA levels reducing cognition. It could
be that vegans have all the DHA they need in their tissues (where it
matters) while having low levels in the
blood. It would be great to know more about this.

Ginny Messina: I agree
that we need more research on the significance of those lower blood
levels of DHA in vegans, and also on the effects and potential
benefits of DHA/EPA (eicosapentaenoic acid, another long-chain
omega-3 fatty acid) supplements for vegans.

Zinc
is another area where I’d like to see some more data. Vegans often
have lower intakes, and zinc is absorbed less well from plant foods.
Does this matter? Since it’s hard to measure zinc status, and
indeed the effects of the lower intakes among vegans, it’s
something we don’t fully understand.

We
also need much better information about the health and nutrient needs
of older vegans. As a post-menopausal vegan, I’m especially
interested in the relationship of protein intake to health in older
women. It’s so important for preserving muscle mass and for bone
health. There is ongoing discussion among the experts in protein
nutrition about whether recommended intakes for older people are high
enough. I’d like to know more about how that impacts those of us
who are vegan and trying to hold on to every milligram of bone and
muscle we can!

Jack Norris: I’d also add that we don’t know much
about the cancer rates of vegans. I see that a report from the
Adventist Health Study-2 is in the process of being published
indicating that vegans have a 16% reduced risk of cancer compared
with meat eaters. That's actually a disappointingly low risk
reduction, in my opinion. I was hoping for more like the
approximately 50% reduced risk of diabetes for vegans.

What do
you consider to be the chief ‘take home’ message of Vegan for
Life?

Jack Norris: For years, the mantra in the vegan community was
that plants contain all the necessary nutrients for good health with
the implication being that all you had to do was eat a variety of
plant foods and you'd be just dandy.

The
message of Vegan for Life is: "Not so fast - there's more to it
than that."

Ginny Messina: Yes, I think this sums up the message
pretty well. There is a little bit of a learning curve when it comes
to healthy eating. That’s true for any kind of diet, of
course.

You are both Registered Dietitians: does veganism have
a generally positive or negative image among dietitians in
North America?

Jack Norris: My assessment is that it's a mixed bag,
with many RDs thinking it's a great diet and even one to strive for,
but others consider it lacking in too many nutrients. The Academy of
Nutrition and Dietetics (AND) has a position paper that supports the
use of "appropriately planned" vegan diets at all stages of
the life cycle. Many of our colleagues balk at the phrase
"appropriately planned" because they believe all diets
should be appropriately planned. While that is a good point, it's
also true that it's easier to suffer acute nutritional deficiencies
on a vegan diet. Although I appreciate the fact that the AND qualify
their statement, it is annoying to know that, in comparison to the
vegan diet, inappropriately-planned, or unplanned, long-term omnivore
diets can increase the risk for type 2 diabetes and heart disease,
among other problems.

Ginny Messina: I’d say that “mixed bag”
describes it pretty well. Many dietitians are still nervous about
vegan diets, believing that it’s
difficult to meet nutrient needs. In the U.S. the dairy industry has
done an incredible job of convincing even health professionals that
dairy foods are absolutely essential in the diet. But other RDs
embrace veganism for health benefits. I
don’t see many dietitians speaking out on the ethical imperative of
veganism, though. That’s an area where we have a long way to
go.

What are your plans for the future?

Ginny Messina: My goal as always is to help make a vegan diet a safe and realistic
option for as many people as possible. To that end, I plan to keep
writing about vegan nutrition on my blog www.TheVeganRD.com
and elsewhere on the internet. I also volunteer for the vegetarian
practice group of the AND, contributing and reviewing written
materials on vegetarian nutrition for dietitians. I have a book on
vegan nutrition for women being published this summer and am working
on another book for next year.

Jack Norris: I will continue to maintain www.VeganHealth.org
and www.JackNorrisRD.com
to make sure vegans have the latest pertinent information regarding
their diet. And
Vegan Outreach will continue to promote a vegan diet. We are happy to
report that, in the United States, the
demand for meat has decreased in recent years, saving millions of
animals from a lifetime of misery - we plan to continue until our
efforts are no longer needed.

Thank
you for your time and for giving readers the benefit of your
knowledge and experience.